Provider Demographics
NPI:1992975569
Name:FESINMEYER, JENNIFER (MS, NNP-BC, RN)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:
Last Name:FESINMEYER
Suffix:
Gender:F
Credentials:MS, NNP-BC, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1959 NE PACIFIC ST
Mailing Address - Street 2:BOX #356077
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98195-6077
Mailing Address - Country:US
Mailing Address - Phone:206-598-4606
Mailing Address - Fax:
Practice Address - Street 1:1959 NE PACIFIC ST
Practice Address - Street 2:BOX #356077
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98195-6077
Practice Address - Country:US
Practice Address - Phone:206-598-4606
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-03-10
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN113825163WN0002X
AZAP3055363LN0005X
WA60264767163WN0002X
WA60264769363LN0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0005XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal, Critical Care
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care